Post-traumatic stress disorder (PTSD) is a serious mental health condition that affects millions of Americans. PTSD is generally triggered by a traumatic event, such a warfare, car accident, physical assault, or sexual abuse. PTSD can cause nightmares, flashbacks, anxiety, and interfere with normal activities. Treatment can help individuals with PTSD recover or cope with the disorder.
What is Post-Traumatic Stress Disorder?
According to the American Psychiatric Association (APA), posttraumatic stress disorder is:
“a psychiatric disorder that may occur in people who have experienced or witnessed a traumatic event such as a natural disaster, a serious accident, a terrorist act, war/combat, or rape or who have been threatened with death, sexual violence or serious injury.”
After experiencing such a traumatic event or continued stress, it can be difficult to adjust to everyday life that is generally absent from the threats of harm, violence, and abuse. Continued symptoms of PTSD interfere with relationships, work or school, and the ability to perform activities of daily living.
The first step to managing PTSD is generally to recognize that there may be a problem and seek treatment. Treatment is important because evidence shows that treatment is effective for many people suffering from PTSD. According to the Office of Veteran's Affairs (VA), 53% of people who receive trauma-focused psychotherapy and 42% of people who take medication will no longer meet the criteria for PTSD.
History of PTSD in America
The term PTSD is relatively new but the problem has existed for thousands of years. Even in Shakespeare's Henry IV, the wife of a soldier describes his sleep disturbances, isolation, loss of interest in previously enjoyed activities, agitation, and changed behavior after regular involvement in warfare.
In the Civil War, mental disorders caused by warfare were referred to as “nostalgia,” and viewed as a weakness of will. The condition was also called “soldier's heart,” or “irritable heart.” During the First World War, the traumatic mental injuries suffered by soldiers were referred to as “shell shock.” In World War 2, traumatic responses to combat were called “battle fatigue,” or “combat fatigue.” It was not until 1980 that the term “post-traumatic stress disorder” was accepted as a diagnosis by the American Psychiatric Association (APA).
Unfortunately, a lot of the misunderstanding about the disorder remains from the days when it was considered a sign of weakness. As a result, many people who suffer from PTSD do not speak out about their experience or problems, fail to get treatment, and continue suffering the harmful mental health disorder.
According to the National Center for PTSD, about 7-8% of the U.S. population will have PTSD at some point in their lives. About 4% of men and 10% of women develop PTSD sometime in their lives. For men, the trauma is more likely to be caused by accidents, assault, combat, or witnessing death or injury. For women, the trauma is more likely to be sexual assault or child sexual abuse.
An estimated 3.6% of U.S. adults had PTSD in the past year. Impairment caused by PTSD ranges from mild to serious, with more than 1/3rd of individuals with PTSD experiencing serious impairment. Even adolescents can experience PTSD, with an estimated 5% of those aged 13 to 18 having PTSD.
Symptoms of PTSD
The signs and symptoms of PTSD can start shortly after a traumatic event or develop over the course of months or years. Symptoms can generally be categorized into one of 4 groups:
- Intrusive memories
- Avoidance symptoms
- Arousal and activity or physical and emotional reactions
- Negative thinking and mood symptoms
- Recurring and unwanted distressing memories
- Severe emotional distress or reactions to things that remind the person of the traumatic event
- Trying to avoid thinking about the event
- Avoiding places, people, or activities that remind the person of the traumatic event
Arousal and emotional reactions
- Being easily startled
- Fight or flight feelings
- Feeling tense
- Difficulty sleeping
- Angry outbursts
Negative thinking and mood
- Trouble remembering details of the traumatic event
- Negative thoughts
- Feelings of guilt, shame, and blame
- Loss of interest in normal activities
A diagnosis of PTSD generally requires all of the following occurring for at least one month:
- One or more re-experiencing symptoms
- One or more avoidance symptoms
- Two or more arousal and reactivity symptoms
- Two or more cognition and mood symptoms
Causes of Post-Traumatic Stress Disorder
PTSD is generally traced to one or more traumatic events. This could include a single occurrence of being the victim of a traumatic event or witnessing another person injured or harmed. It may also involve continued exposure or repeated trauma, such as spending months in a combat situation or repeated sexual abuse as a child. Some of the possible causes of PTSD include:
- Warfare/Military combat
- Serious car or truck accident
- Industrial or construction accident
- Dog or animal attack
- Burn injury
- Domestic abuse
- Child abuse
- Sexual abuse
- Sexual assault
- Life-threatening medical diagnosis
- Natural disaster
- Robbery or mugging
- Terrorist attack
- Threatened with a weapon
PTSD and Auto Accidents
Automobile accidents can be very traumatic, especially when they involve serious injury or death. Many people describe a serious car accident as seeing their life flash before their eyes. Even if the individual does not suffer permanent injuries, the memory of the accident, coming so close to possible death, or watching a loved one die can cause the experience to interfere with everyday life for months or years after the accident.
Permanent injuries after a car accident, bike accident, truck crash, or motorcycle accident can also increase the risk of PTSD. Suffering chronic pain, brain injury, loss of a limb, or permanent disfigurement are regular reminders of the traumatic accident and can cause flashbacks, frustration, and avoidance of interacting with others because of the injury.
PTSD and Construction/Industrial Accidents
Construction sites and industrial floors are some of the most dangerous workplaces. Injuries are common in these jobs and the injuries are often severe, life-threatening, or fatal. These accidents can be traumatic for coworkers who witness a fatal accident or serious injury, including:
- High falls
- Chemical burns
- Crushing injuries
- Caught between machinery or vehicles
- Struck by machinery
- Burn injuries
Workplace injuries may be covered by workers' compensation. Workers' comp is supposed to provide the necessary medical treatment. Unfortunately, the employer or insurance company may try to avoid paying for mental health treatment, even if the injury victim suffers a serious mental disorder because of the accident. Make sure you receive mental and physical health treatment after a traumatic injury.
PTSD and Burn Injuries
Burn injuries can be devastating for victims and their families. Burn injuries can be especially tragic when they happen to young children and parents have to witness the pain and feelings of powerlessness when watching their child suffer. Burn injuries can be fatal, with severe risks of hypothermia and infection. If the injury victim does recover, they may be left with extensive scarring and disfiguring injuries.
PTSD is commonly associated with burn injury survivors. Accident victims may have flashbacks of the burning accident, nightmares, feeling on edge, avoiding the types of places where the accident occurred, and maintaining negative or distorted thinking. Recognizing the problems of PTSD early on and getting treatment can increase the chances of success.
PTSD and Sexual Assault and Abuse
Most people think about PTSD being caused by warfare or combat situations. However, it can be caused by traumatic events even if those events are not seen by others or talked about. Sexual abuse survivors and survivors of sexual assault often experience PTSD. Unfortunately, if the victim has not talked about the abuse or assault, it may be more difficult for them to seek help for their mental injuries that continue to affect them.
After sexual abuse or sexual assault, victims may face the common symptoms of PTSD, including:
- Avoiding remembering the assault
- Feeling tense
- Have difficulty sleeping
- Feeling guilty, shame, or blame
- Loss of interest in normal activities
Many victims of assault or abuse do not get help because they blame themselves or feel hopeless because the attacker was never brought to justice. However, it is important for people who have suffered abuse or sexual violence to seek treatment for their mental health.
PTSD and Cancer Diagnosis
Many people describe getting a serious medical diagnosis as a “death sentence.” This is most common with advanced stages of cancer, where a doctor gives a patient a prognosis of a few months to live. No matter what the person was like before the diagnosis, a prediction that they will likely die in the near future changes their whole perspective on life.
A cancer diagnosis can be even more difficult if the patient finds out that the cancer should have been detected earlier but a doctor failed to recognize the signs of cancer, failed to diagnose cancer, or misdiagnosed symptoms as another condition. The depression and feelings caused by PTSD may make the victim hesitant to come forward about the medical negligence but filing a malpractice claim can be a way to help prevent similar tragedies in the future.
In movies, a life-threatening medical diagnosis is a reason to check off a bucket list but in reality, most people turn inward after such a diagnosis. This can cause someone to go into a deep depression, feel hopeless, dread, anxiety, and fear. A cancer diagnosis can symptoms of PTSD including nightmares, feelings of guilt or shame, difficulty sleeping, continuous fear or anger, and avoiding places or people that trigger these feelings.
One of the unfortunate aspects of a cancer diagnosis is that even after recovery, remission, and surviving cancer, many cancer survivors still feel a sense of fear or dread that the cancer will return. After surviving cancer, it is important for patients to be aware of the possibility of developing PTSD and get treatment so they can take care of their mental health.
PTSD and Medical Malpractice Injuries
Other medical malpractice injuries can lead to PTSD. One of the problems that patients face after they were injured because of a medical error is they often blame themselves for the doctor's mistakes. They wonder what would have happened if they got a second opinion, if they'd asked more questions, or if they'd voiced their concerns louder. Unfortunately, these victims are faced with the consequences of the doctor's errors daily when looking at their scars, disfiguring injuries, or amputated limb.
Victims of medical malpractice need to address their mental health after an injury. The patients may not feel like they are in a position to seek mental health care or pay for it but a medical malpractice lawsuit may be able to recover damages that include mental health treatment, medical bills, loss of income, and pain and suffering.
Treatment for Post-Traumatic Stress Disorder
PTSD generally does not just go away on its own. Treatment can make a big difference for those dealing with PTSD, as well as their loved ones. There are a number of treatment options for people with PTSD. Generally, treatment includes psychotherapy and/or medication.
Psychotherapy for PTSD
Trauma-focused psychotherapy is the most common treatment for PTSD. This treatment focuses on the memory of the event, including prolonged exposure therapy (PE), cognitive processing therapy (CPT), and eye movement desensitization and reprocessing (EMDR). Some people with PTSD also find individual therapy and group therapy beneficial.
Medication for PTSD
There are a number of medications that may be helpful for people with PTSD. Selective serotonin reuptake inhibitors (SSRIs) include Paxil, and Zoloft. Serotonin-norepinephrine reuptake inhibitors (SNRIs) like Effexor may also be beneficial. Monoamine oxidase inhibitors (MAOIs) antipsychotics, or beta-blockers may also be prescribed for PTSD and associated mental disorders. Anti-anxiety medications like benzodiazepines are often avoided because of their potential for addiction and other side effects.
Patients and doctors may need to try a few combinations and types of therapy and medication to find what works best for the individual. However, it is important to talk to an experienced medical professional about the issue and avoid trying to take care of the problem on one's own.
Many people with PTSD “self-medicate” to cover-up the symptoms of their condition by using alcohol or drugs. This often makes the problems worse by compounding problems without addressing the underlying issues. Drugs and alcohol can lead to physical damage, problems with law enforcement, and financial problems.
Help After Suffering PTSD in an Accident or Medical Mistake
Mental health is just as important as physical health. Injury victims should be compensated for all their losses caused by the negligence of another. If you were injured in a car accident, burn injury, dog attack, or because of medical malpractice, talk to an experienced trial attorney about your options. Do not hesitate to contact Gilman & Bedigian today for a free consultation.